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2015, October 7-11
San Diego
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Continued Rising Mortality from Hepatitis C Virus in the United States, 2003-2013
  "Political attitudes: No strong advocacy group: most HCV patients are former injection drug users"
Reported by Jules Levin
IDSA 2015
Oct 7-11 San Diego, CA
Scott Holmberg, MD, MPH, FIDSA
Kathleen N. Ly, MPH
Jian Xing, PhD
Anne C. Moorman, BSN, MPH
Epidemiology and Surveillance Branch,
Division of Viral Hepatitis, CDC
Mortality among Persons in Care with Hepatitis C Virus Infection--The Chronic Hepatitis Cohort Study (CHeCS), 2006-2010: liver disease deaths 12 times higher [than general population] (CID 2014)........http://www.natap.org/2014/HCV/021114_03.htm......."The age-adjusted mortality rate for liver disease in CHeCS was twelve times higher than the MCOD rate......mean age of death was 59 years, 15 years younger than MCOD deaths......only 19% of all CHeCS decedents and only 30% of those with recorded liver disease had HCV listed on their death certificates.....This effect was seen with extra-hepatic causes as well" IDSA/2014: Mortality among Persons in Care with Hepatitis C Virus Infection-Chronic Hepatitis Cohort Study (CHeCS), 2006 -2010: HCV deaths grossly Underreported mortality rate 12 times higher than the general population, average age of death is 59 for HCV & 74 for general population, a 15 year difference.......http://www.natap.org/2013/IDSA/IDSA_44.htm
HCV USA/Prevalence 8-9 Million?? - (10/09/15) ......estimating the Number of Persons Who Inject Drugs in the United States by Meta-Analysis to Calculate National Rates of HIV and Hepatitis C Virus Infections.....impact of immigrants on HCV prevalence......HCV among IDUs & the homeless, incarcerated.....[from Jules: coinfection prevalence is often mischaracterized when we say 25-30% with HIV have HCV. HCV is most common in HIV+ among those who got HIV through IDU & 80-90% of IDUs have HCV and so know most of these patients get their care through public healthcare: Ryan White, Medicaid; we know most of the IDUs with HCV & HIV are African-American or Latino.


"From 2003-2013, deaths with hepatitis C recorded on death certificates increased from 11,051 in 2003 to 19,368 in 2013 (Figure; Cochrane-Armitage trend test, p=0.01), while deaths associated with all 59 other notifiable infectious conditions decreased from 24,434 in 2003 to 18,002 in 2013 (Figure, trend, p=0.06). In 2012, the number of deaths associated with hepatitis C surpassed that with all 59 other notifiable infectious conditions. In 2013, 51.1% (n=9,899) of HCV-related deaths occurred among persons aged 55-64 years (mean age, 59.7 years)......Conclusion: Despite improving therapies, deaths from hepatitis C-mainly among persons aged 55-64 years-- continue to rise, indicating the poor penetrance of therapies to the 3 million Americans estimated to be infected with HCV. Moreover, since only 19% of HCV-infected patients who die have HCV listed anywhere on their death certificate, these data underestimate the problem."